Mercury in Health Care: WHO Policy Paper

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Mercury in Health Care WHO Policy Paper

• Hisashi Ogawa
• WHO Western Pacific Regional Office

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Sources of mercury in health care

• Thermometers
• Sphygmomanometers
• Dental amalgam
• Gastrointestinal tubes
• Laboratory chemicals
• Pharmaceutical products
• Electrical applications
• Medical waste incineration, open burning, burning
  in barrels, gasification, pyrolysis, etc.

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Occupational exposure to mercury

• Common pathway is inhalation of mercury vapours
  (odourless and colourless)
• Permissible concentration for occupational
  exposure by NIOSH 0.05 mg/m3
• Equipment breakage and spills occur frequently,
  but risk perception is low
• Spillage accident is often not reported, and
  handled carelessly with no protective gear

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Mercury release from health care

• Health care facilities are one of the main
  sources of mercury release into the atmosphere
  because of emissions from medical waste
  incineration
• Health care facilities are responsible for
  mercury pollution taking place in water bodies
  from the release of untreated wastewater
• Mercury contained in dental amalgam is the
  greatest source of mercury vapour in
  non-industrial settings

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Strategies

• WHO recognizes that a significant portion of
  mercury release comes from the health-care
  sector, and therefore proposes to work with
  countries through the following strategies
• Short- term
• Medium-term
• Long-term

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Short-term strategies

• Develop clean up and waste handling procedures
• Procedures should include
• - Spill clean up response,
• - Educational programmes
• - Use of protective gear
• - Waste storage containment
• - Staff training
• Countries to initiate phasing out process

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Medium-term strategies

• Reduce the number of unnecessary use of mercury
  equipment
• Inventory of mercury use and the categorization
  of items into immediate replaceable and gradually
  replaceable
• Return of replaceable devices to the manufacturer
  or to the provider of alternative devices
• Progressively discourage the sale and use of
  mercury containing devices
• Ensure support to countries so that recovered
  mercury equipment is not recycled back to the
  supply chain

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Long-term strategies

• Support a ban of use of mercury devices and
  promote the use of alternatives
• Support in developing implementing national
  plan, policies legislation on mercury
• Support allocation of human and financial
  resources
• Promoting principles of environmentally sound
  management of health-care waste under the Basel
  Convention